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Participatory development of an mHealth intervention delivered in general practice to increase physical activity and reduce sedentary behaviour of patients with prediabetes and type 2 diabetes (ENERGISED)

Novak, J; Jurkova, K; Lojkaskova, A; Jaklova, A; Kuhnova, J; Pfeiferova, M; Kral, N; Janek, M; Omcirk, D; Malisova, K; et al. Novak, J; Jurkova, K; Lojkaskova, A; Jaklova, A; Kuhnova, J; Pfeiferova, M; Kral, N; Janek, M; Omcirk, D; Malisova, K; Maes, I; Van Dyck, D; Wahlich, C; Ussher, MH; Elavsky, S; Cimler, R; Pelclova, J; Tufano, JJ; Steffl, M; Seifert, B; Yates, T; Harris, T; Vetrovsky, T (2024) Participatory development of an mHealth intervention delivered in general practice to increase physical activity and reduce sedentary behaviour of patients with prediabetes and type 2 diabetes (ENERGISED). BMC Public Health, 24. p. 927. ISSN 1471-2458 https://doi.org/10.1186/s12889-024-18384-2 (In Press)
SGUL Authors: Ussher, Michael Henry Harris, Teresa Jane

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Abstract

Background The escalating global prevalence of type 2 diabetes and prediabetes presents a major public health challenge. Physical activity plays a critical role in managing (pre)diabetes; however, adherence to physical activity recommendations remains low. The ENERGISED trial was designed to address these challenges by integrating mHealth tools into the routine practice of general practitioners, aiming for a significant, scalable impact in (pre)diabetes patient care through increased physical activity and reduced sedentary behaviour. Methods The mHealth intervention for the ENERGISED trial was developed according to the mHealth development and evaluation framework, which includes the active participation of (pre)diabetes patients. This iterative process encompasses four sequential phases: (a) conceptualisation to identify key aspects of the intervention; (b) formative research including two focus groups with (pre)diabetes patients (n = 14) to tailor the intervention to the needs and preferences of the target population; (c) pre-testing using think-aloud patient interviews (n = 7) to optimise the intervention components; and (d) piloting (n = 10) to refine the intervention to its final form. Results The final intervention comprises six types of text messages, each embodying different behaviour change techniques. Some of the messages, such as those providing interim reviews of the patients’ weekly step goal or feedback on their weekly performance, are delivered at fixed times of the week. Others are triggered just in time by specific physical behaviour events as detected by the Fitbit activity tracker: for example, prompts to increase walking pace are triggered after 5 min of continuous walking; and prompts to interrupt sitting following 30 min of uninterrupted sitting. For patients without a smartphone or reliable internet connection, the intervention is adapted to ensure inclusivity. Patients receive on average three to six messages per week for 12 months. During the first six months, the text messaging is supplemented with monthly phone counselling to enable personalisation of the intervention, assistance with technical issues, and enhancement of adherence. Conclusions The participatory development of the ENERGISED mHealth intervention, incorporating just-in-time prompts, has the potential to significantly enhance the capacity of general practitioners for personalised behavioural counselling on physical activity in (pre)diabetes patients, with implications for broader applications in primary care.

Item Type: Article
Additional Information: © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Keywords: 1117 Public Health and Health Services, Public Health
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: BMC Public Health
ISSN: 1471-2458
Dates:
DateEvent
31 March 2024Published
18 March 2024Accepted
Projects:
Project IDFunderFunder ID
NU21–09–00007Czech Health Research CouncilUNSPECIFIED
URI: https://openaccess.sgul.ac.uk/id/eprint/116365
Publisher's version: https://doi.org/10.1186/s12889-024-18384-2

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